| NPI | 1376830174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 69782) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: GA 069782) | |
| 208M00000X Hospitalist (Licence: GA 069782) | |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2015-02-04 |